FORM 58 C
[See rule 11MA]

Report to be submitted under clause (ii) of sub-section (4) of section 35AC of the Income-tax Act, 1961 to the National Committee by an approved Association or Institution

Reporting period________to__________
1. Name of the association or institution :
2. PAN/assessment Circle/Ward :
3. Address for communication :
4. Reference number by which the National Committee
has given approval to the association or institution
:
5. Whether any complaint has been received against the
persons managing the affairs of the association or
institution regarding financial irregularities,
nepotism, discrimination etc. If yes, the details
thereof
:
6. Whether any eligible person has been discriminated
from getting the benefits of the eligible project or
scheme on the basis of religion, race, caste, sex, place
of birth etc. If yes, the details thereof
:
7. Whether there is any deviation from the original
purpose set out for the association or institution. If
yes, the details thereof
:
8. Whether the persons managing the affairs of the
association or institution have received any personal
benefits from the association or institution other than
the remuneration or honorarium allowable in their
case. If yes, the details thereof
:
Certified that the above information is true to the best of my knowledge and belief.
Place :__________
Date :___________
___________________
Name and designation